Pt/Ot Haad Simulation 7

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1/100 Questions

A 40 year-old male with a history of low back pain has been receiving physical therapy for 12 weeks. The patient is employed as a loading dockworker. He performs repetitive lifting and carrying of boxes weighing between 15 and 30 pounds. An appropriate engineering control to reduce the stresses of lifting and carrying would be to:
- Issue the employee a back support belt.
- Provide a two-wheel handcart for use in moving the boxes.
- Require the worker to attend a class in using correct body mechanics while performing the job.
- Use job rotation.

About This Quiz

This is a Simulated Examination for Gulf Physical Therapy/ Occupational Therapy Examinations taken from Last Month's HAAD Feedbacks.
This examination contains 100 of the most UPDATED EXAMS from Abu Dhabi, KSA, and UAE.
Take this examination for 120 minutes.
You need to get 86% to pass the HAAD. 60% to pass MOH, DHA, or Prometrics.
Please text 0919-286-29-29 in the See morePhilippines or visit our website www. Ptonline. Weebly. Com
THIS IS YOUR ASSESSMENT FOR ANY GULF Physical Therapy/ Occupational Therapy EXAMINATIONS INCLUDING HAAD, SAUDI PROMETRICS, DUBAI DHA, AND UAE MOH.
THE QUESTIONS HERE ARE TAKEN FROM THIS ACTUAL EXAMINATIONS, SO PASSING THIS ASSESSMENT EXAM WILL GIVE YOU A HIGH PROBABILITY OF PASSING

Questions and Answers

2.

Common compensatory postures you would expect for a patient diagnosed with fixed severe forefoot varus are:
- Excessive ankle dorsiflexion and medial rotation of the femur.
- excessive midtarsal supination and lateral rotation of the tibia.
- Subtalar pronation and medial rotation of the tibia.
- Toeing-in and lateral rotation of the femur.
Correct Answer

A. Excessive ankle dorsiflexion and medial rotation of the femur.

Explanation

Patients diagnosed with fixed severe forefoot varus often develop compensatory postures to accommodate for the abnormal foot alignment. Excessive ankle dorsiflexion occurs as the body attempts to bring the forefoot into contact with the ground. Medial rotation of the femur helps to align the knee and foot, compensating for the varus position. This combination of compensatory postures allows for improved weight distribution and stability during gait.

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3.

A patient has undergone surgery and subsequent immobilization to stabilize the olecranon process. The patient now exhibits an elbow flexion contracture. In this case, an absolute CONTRAINDICATION for joint mobilization would be:
- empty end-feel.
- Firm end-feel.
- soft end-feel.
- Springy end-feel.
Correct Answer

A. Firm end-feel.

Explanation

The patient has undergone surgery and subsequent immobilization to stabilize the olecranon process, and now exhibits an elbow flexion contracture. A firm end-feel indicates that there is a hard resistance to further movement, which could suggest the presence of a bony block or joint pathology. In this case, attempting joint mobilization could potentially worsen the condition or cause further damage, making it an absolute contraindication.

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4.

You observe a physical therapist assistant ambulate a patient for the first time after a left total hip replacement. The patient is using crutches and is practicing on a level surface. The PTA should guard the patient by standing slightly:
- Behind and to the intact side, one hand on the gait belt.
- behind and to the left side, one hand on the gait belt.
- Behind the patient with both hands on the gait belt.
- in front of the patient, walking backward, with one hand on the gait belt and one hand on the shoulder.
Correct Answer

A. Behind the patient with both hands on the gait belt.

Explanation

The correct answer is behind the patient with both hands on the gait belt. This position allows the physical therapist assistant to provide the necessary support and stability to the patient during ambulation. Being behind the patient allows the PTA to closely monitor the patient's movement and intervene if necessary. Placing both hands on the gait belt ensures a secure grip and control over the patient's movements.

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5.

A 13 year-old severed the median nerve three days ago when his hand went through a glass window. To determine the motor function of the nerve you perform a chronaxie test. At this time you would expect the chronaxie of the nerve to be:
- Absent.
- Decreased.
- Increased.
- unaffected.
Correct Answer

A. Absent.

Explanation

The chronaxie test is used to determine the excitability of a nerve by measuring the duration of an electric stimulus needed to elicit a response. In this case, the 13-year-old severed the median nerve three days ago, which means that the nerve is completely cut off and unable to transmit any signals. Therefore, there would be no response to the electric stimulus, indicating that the chronaxie of the nerve is absent.

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6.

A patient has lumbar spinal stenosis encroaching on the spinal cord. The physical therapist should educate the patient to AVOID:
- bicycling.
- Rowing.
- swimming using a crawl stroke.
- Tai Chi.
Correct Answer

A. swimming using a crawl stroke.

Explanation

Swimming using a crawl stroke should be avoided for a patient with lumbar spinal stenosis encroaching on the spinal cord. This is because the crawl stroke requires repetitive extension of the spine, which can exacerbate the symptoms and further compress the spinal cord. It is important for the patient to avoid activities that put excessive strain on the spine and instead focus on low-impact exercises that promote stability and flexibility, such as bicycling, rowing, and Tai Chi.

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7.

A patient with post-polio syndrome presents in your clinic with symptoms of myalgia and increasing fatigue. He is wearing a KAFO which he has had for 10 years. When walking, you observe that he rises up over the sound limb to advance the orthotic limb forward. Your BEST intervention is to provide:
- a manual wheelchair with reclining back and elevating legrests.
- A shoe lift on the orthotic side.
- a shoe lift on the sound side.
- an electric wheelchair with joystick.
Correct Answer

A. A shoe lift on the orthotic side.

Explanation

The patient's symptoms of myalgia and increasing fatigue, along with the observation of rising up over the sound limb, suggest that there may be a leg length discrepancy. Providing a shoe lift on the orthotic side would help to correct the leg length difference, improve the patient's gait, and potentially alleviate the symptoms. The other interventions, such as a manual wheelchair with reclining back and elevating legrests or an electric wheelchair with joystick, may not directly address the underlying issue of leg length discrepancy. A shoe lift on the sound side would further exacerbate the discrepancy and potentially worsen the patient's symptoms.

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8.

Your patient has moderate spasticity of the biceps brachii on the left as a result of a CVA. You choose to use electrical stimulation to temporarily decrease the effects of hypertonicity in order to work on ADL activities. Your objective in applying the current is to:
- fatigue the ipsilateral biceps brachii.
- Stimulate the contralateral biceps brachii.
- Stimulate the contralateral triceps.
- Stimulate the ipsilateral triceps.
Correct Answer

A. Stimulate the contralateral biceps brachii.

Explanation

By applying electrical stimulation to the contralateral biceps brachii, the objective is to stimulate the muscle and temporarily decrease the effects of hypertonicity. This can help in working on ADL activities by promoting relaxation and reducing spasticity in the affected muscle. By stimulating the contralateral biceps brachii, it can also help improve overall muscle balance and coordination between the two arms.

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9.

You are working with a four year-old child who has myelodysplasia at the L5 level. At this level the most appropriate orthosis to recommend for ambulation would be a (an):
- Ankle-foot orthosis.
- Knee-ankle-foot orthosis.
- parapodium.
- Reciprocating gait orthosis.
Correct Answer

A. Knee-ankle-foot orthosis.

Explanation

Given that the child has myelodysplasia at the L5 level, the most appropriate orthosis for ambulation would be a knee-ankle-foot orthosis. This orthosis provides support and stability to the knee, ankle, and foot, allowing the child to maintain proper alignment and control while walking. It helps compensate for muscle weakness or paralysis in the lower extremities and promotes a more natural gait pattern. The knee-ankle-foot orthosis is specifically designed to provide the necessary level of support and mobility for individuals with myelodysplasia at the L5 level.

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10.

An eleven-year-old male was referred to physical therapy with complaints of vague pain at his right hip and thigh which radiates to his knee. His AROM is restricted in abduction, flexion, and internal rotation. A gluteus medius gait was observed with ambulation for 100 feet. Appropriate PT intervention would include:
- closed-chain partial weight-bearing lower extremity exercises for slipped capital femoral epiphysis.
- Hip joint mobilization to improve the restriction in motion as the result of Legg-Calvé Perthe’s disease
- Open-chain strengthening of his right hip abductors and internal rotators for avascular necrosis of the hip
- Orthoses to control lower extremity position as the result of femoral anteversion.
Correct Answer

A. Hip joint mobilization to improve the restriction in motion as the result of Legg-Calvé Perthe’s disease

Explanation

The patient's symptoms of vague pain at the right hip and thigh, restricted AROM in abduction, flexion, and internal rotation, and observation of a gluteus medius gait suggest a hip pathology. Legg-Calvé Perthe's disease is a condition that affects the blood supply to the femoral head, leading to avascular necrosis and restricted motion. Hip joint mobilization is a common intervention used to improve joint mobility and decrease pain in patients with Legg-Calvé Perthe's disease. Therefore, hip joint mobilization is the appropriate PT intervention for this patient.

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11.

A researcher states that he expects that there will be no significant difference between 20 and 30 year-olds after a 12 week exercise training program using exercise heart rates and myocardial oxygen consumption as measures of performance. The kind of hypothesis that is being used in this study is a (an):
- directional hypothesis.
- experimental hypothesis.
- null hypothesis.
- Research hypothesis
Correct Answer

A. experimental hypothesis.

Explanation

The researcher's statement suggests that they expect a significant difference between 20 and 30 year-olds after the exercise training program. This indicates that they have a specific expectation and are testing a cause-and-effect relationship between the exercise program and the performance measures. Therefore, the hypothesis being used in this study is an experimental hypothesis.

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12.

A physical therapist was treating a patient and the patient in the next bed was uncomfortable and asked the therapist to move his leg. The therapist placed the leg on 2 pillows as requested by the patient. Unknown to the therapist this patient had a femoral artery graft 2 days previously. As a result the graft became occluded and the patient was rushed to surgery for a replacement. The patient claimed the therapist placed his leg too high on the pillows causing the occlusion of the original graft and sued for malpractice. The hospital administrator decided:
- It was the patient’s fault for requesting the position change and therefore supported the action of the physical therapist.
- That the physical therapist was functioning according to common protocols of the institution and thus supported the actions of the therapist.
- That the therapist was functioning outside the common protocols of the hospital, and therefore did not support the actions of the physical therapist.
- to counter-sue the patient because he was responsible for requesting the position change.
Correct Answer

A. That the therapist was functioning outside the common protocols of the hospital, and therefore did not support the actions of the physical therapist.

Explanation

The hospital administrator decided that the therapist was functioning outside the common protocols of the hospital and did not support the actions of the physical therapist. This decision suggests that the hospital had established protocols for the placement of patients' legs, and the therapist deviated from these protocols by placing the leg too high on the pillows. This deviation led to the occlusion of the original graft and subsequent complications for the patient. Therefore, the hospital administrator held the therapist responsible for the malpractice.

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13.

A 26 year-old female has a 3 year history of multiple sclerosis. One of her disabling symptoms is a persistent and severe diplopia which leaves her frequently nauseated and immobile. An appropriate intervention strategy to assist her in successfully participating in rehabilitation would be to:
- Give her a soft neck collar to limit head and neck movements.
- Give her special glasses which magnify images.
- have her close her eyes and practice movements without visual guidance.
- patch one eye.
Correct Answer

A. have her close her eyes and practice movements without visual guidance.

Explanation

An appropriate intervention strategy to assist the 26 year-old female with multiple sclerosis in successfully participating in rehabilitation would be to have her close her eyes and practice movements without visual guidance. This is because her persistent and severe diplopia (double vision) is one of her disabling symptoms, which affects her ability to move and causes nausea. By closing her eyes and practicing movements without visual guidance, she can focus on her proprioception (awareness of body position and movement) and improve her mobility without the interference of double vision.

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14.

The MOST appropriate positioning strategy for a patient recovering from acute stroke who is in bed and demonstrates a flaccid upper extremity is:
- sidelying on the affected side with the affected upper extremity flexed overhead.
- Sidelying on the sound side with the affected upper extremity supported on a pillow with the shoulder protracted and elbow extended.
- Supine with the affected hand positioned on stomach.
- Supine with the affected upper extremity positioned close to the side of the trunk.
Correct Answer

A. Supine with the affected hand positioned on stomach.

Explanation

The supine position with the affected hand positioned on the stomach is the most appropriate positioning strategy for a patient recovering from acute stroke with a flaccid upper extremity. This position helps to prevent shoulder subluxation and promotes proper alignment of the arm and hand. Placing the hand on the stomach also helps to reduce edema and maintain a functional position for the hand.

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15.

A patient presents with a large plantar ulcer that will be debrided in the whirlpool. The foot is cold, pale, and painless. The condition that would most likely result in this clinical presentation is:
- Acute arterial insufficiency.
- chronic arterial insufficiency.
- Chronic venous insufficiency.
- Deep venous thrombosis.
Correct Answer

A. chronic arterial insufficiency.

Explanation

Chronic arterial insufficiency is the most likely condition to result in the given clinical presentation. In chronic arterial insufficiency, there is a gradual narrowing or blockage of the arteries that supply blood to the lower extremities. This leads to poor blood flow, causing the foot to become cold, pale, and painless. The large plantar ulcer is a result of the inadequate blood supply, which impairs wound healing. Acute arterial insufficiency would present with more severe symptoms such as severe pain, pallor, and coolness, while chronic venous insufficiency and deep venous thrombosis would not typically cause a painless foot ulcer.

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16.

A patient has been referred to you following a fracture of the femur six months ago. The cast was removed, but the patient was unable to volitionally contract the quadriceps. You decide to apply electrical stimulation to the quadriceps muscle. Your choice of electrode placement and electrical stimulation duty cycle (on:off ratio) would consist of:
- large electrodes, closely spaced; 10:30.
- large electrodes, widely spaced; 10:30.
- small electrodes, closely spaced; 10:30.
- Small electrodes, widely spaced; 10:10.
Correct Answer

A. small electrodes, closely spaced; 10:30.
17.

While setting a patient up for cervical traction, you notice a purplish mole with rough edges on the patient’s neck. You:
- Call the physician immediately and report your findings.
- document the skin condition and keep a watchful eye on it.
- Tell the patient if it bleeds at all to report it to his physician.
- Treat the patient but cover the mole with a gauze pad.
Correct Answer

A. document the skin condition and keep a watchful eye on it.

Explanation

It is important to document the presence of the purplish mole with rough edges on the patient's neck and keep a watchful eye on it. This is because the mole may be indicative of a potential skin condition or even skin cancer. By documenting it, healthcare professionals can monitor any changes in the mole over time and determine if further action, such as referral to a physician, is necessary. This approach ensures that the patient's condition is properly managed and any potential issues are addressed in a timely manner.

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18.

A 15 year-old male suffered traumatic brain injury and multiple fractures following a motor vehicle accident. He is recovering in the intensive care unit. Your referral states PROM and positioning. On day 1 he is semi-alert and drifts in and out while you are working with him. On day 2 you become concerned because you observe signs suggestive of increasing intracranial pressure. You promptly report these symptoms to his physician. The signs that would be cause for immediate action in this case would be:
- decreasing consciousness with slowing of pulse and Cheyne-Stokes respirations.
- Decreasing function of cranial nerves IV, VI, and VII.
- Developing irritability with increasing symptoms of photophobia, disorientation and restlessness.
- Positive Kernig’s sign with developing nuchal rigidity.
Correct Answer

A. decreasing consciousness with slowing of pulse and Cheyne-Stokes respirations.

Explanation

The signs that would be cause for immediate action in this case are decreasing consciousness with slowing of pulse and Cheyne-Stokes respirations. These symptoms suggest increasing intracranial pressure, which can be life-threatening. Slowing of the pulse indicates decreased brain perfusion, while Cheyne-Stokes respirations are characterized by alternating periods of deep and shallow breathing, indicating impaired brainstem function. Promptly reporting these symptoms to the physician is crucial to ensure appropriate intervention and prevent further complications.

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19.

You have received a referral for a 42 year-old patient who has a neurapraxia involving the ulnar nerve secondary to an elbow fracture. Based on your knowledge of this condition, you expect that:
- regeneration is unlikely because surgical approximation of the nerve ends was not performed.
- Nerve dysfunction will be rapidly reversed, generally in 2-3 weeks.
- Regeneration is likely after 2-21/2 years.
- regeneration is likely in 6-8 months.
Correct Answer

A. regeneration is unlikely because surgical approximation of the nerve ends was not performed.

Explanation

The correct answer states that regeneration is unlikely because surgical approximation of the nerve ends was not performed. Neurapraxia refers to a temporary loss of nerve function due to nerve compression or injury. In this case, the ulnar nerve has been affected due to an elbow fracture. Surgical approximation of the nerve ends is typically necessary for nerve regeneration in cases of neurapraxia. Without surgical intervention, the nerve ends may not be properly aligned, making regeneration unlikely. Therefore, the answer accurately explains the expected outcome in this scenario.

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20.

After three weeks of teaching a patient how to ambulate with bilateral crutches and a touch down gait, you determine the most appropriate kind of feedback to give to the patient is:
- Continuous feedback in which you provide ongoing verbal cuing during gait.
- immediate feedback given after each practice trial.
- intermittent feedback given at scheduled intervals, every other practice trial.
- Occasional feedback given when consistent errors appear.
Correct Answer

A. intermittent feedback given at scheduled intervals, every other practice trial.
21.

You are a home health physical therapist. During one of your regularly scheduled visits with a 72 year-old male patient, you find him to be confused with shortness of breath and significant generalized weakness. Assessing these symptoms and given his history of hypertension and hyperlipidemia, you suspect:
- He forgot to take his hypertension medication.
- he may be experiencing unstable angina.
- he may be presenting with early signs of myocardial infarction.
- his mental changes are indicative of early Alzheimer’s disease.
Correct Answer

A. he may be experiencing unstable angina.

Explanation

Based on the given symptoms of confusion, shortness of breath, and generalized weakness, along with the patient's history of hypertension and hyperlipidemia, the most likely explanation is that the patient may be experiencing unstable angina. Unstable angina is a condition characterized by chest pain or discomfort that occurs at rest or with minimal exertion, and it is often accompanied by other symptoms like shortness of breath and weakness. Given the patient's age and medical history, it is important to consider cardiovascular issues as a potential cause of his symptoms.

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22.

Physical therapy intervention for a sixty-five year-old male patient with a recent diagnosis of supraspinatus tendinitis with possible impingement syndrome of the right shoulder should emphasize:
- Joint mobilization, use of ice, and rotator cuff strengthening.
- Modalities to reduce inflammation, active assistive range of motion exercises using pulleys, and postural realignment.
- Reducing stresses to abnormal tissues by placing the right upper extremity in a sling, use of ice, and rotator cuff strengthening.
- rest to reduce pain, iontophoresis, and strengthening of the rotator cuff muscles.
Correct Answer

A. Modalities to reduce inflammation, active assistive range of motion exercises using pulleys, and postural realignment.

Explanation

The correct answer is modalities to reduce inflammation, active assistive range of motion exercises using pulleys, and postural realignment. This intervention is appropriate for a patient with supraspinatus tendinitis and possible impingement syndrome. Modalities to reduce inflammation, such as ice, can help alleviate pain and swelling. Active assistive range of motion exercises using pulleys can help improve shoulder mobility and strength. Postural realignment can address any underlying postural issues that may be contributing to the shoulder problem. These interventions aim to reduce pain, improve function, and promote healing in the shoulder joint.

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23.

The recommended time duration for endotracheal suctioning is:
- 1 to 5 seconds.
- 10 to 15 seconds.
- 15 to 20 seconds.
- 5 to 10 seconds.
Correct Answer

A. 15 to 20 seconds.

Explanation

The recommended time duration for endotracheal suctioning is 15 to 20 seconds. This duration allows for effective removal of secretions from the airway while minimizing the risk of complications such as hypoxia and tissue damage. Suctioning for a shorter duration may not adequately clear the airway, while suctioning for a longer duration can lead to tissue trauma and oxygen desaturation. Therefore, 15 to 20 seconds is the optimal time range for endotracheal suctioning.

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24.

A 76 year-old frail older adult is confined to bed in a nursing facility. He has developed a small superficial wound over the sacral area. Since only small amounts of necrotic tissue are present, the physician has decided to use autolytic wound debridement. This is BEST achieved with:
- Forceful irrigations.
- Hydrotherapy.
- Occlusive dressings.
- Wet-to-dry dressings.
Correct Answer

A. Occlusive dressings.

Explanation

Autolytic wound debridement refers to the natural process of using the body's own enzymes and moisture to break down and remove necrotic tissue. Occlusive dressings, such as hydrocolloids or transparent films, create a moist environment that promotes autolysis by trapping the wound exudate. This helps to soften and dissolve the necrotic tissue, allowing it to be easily removed during dressing changes. Forceful irrigations, hydrotherapy, and wet-to-dry dressings are not as effective in creating the necessary moist environment for autolytic debridement.

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25.

Three weeks ago, you instructed your patient in applying conventional (high rate) TENS to the low back to modulate a chronic pain condition. The patient now states that the TENS unit is no longer effective in reducing the pain in spite of increasing the intensity to maximum . You should now advise the patient to:
- Decrease the pulse duration.
- Increase the treatment frequency.
- Switch to low rate TENS.
- switch to modulation mode TENS.
Correct Answer

A. Switch to low rate TENS.

Explanation

The patient's statement that the TENS unit is no longer effective in reducing the pain, even at maximum intensity, suggests that they may have developed a tolerance to the high rate TENS. Switching to low rate TENS can be a more effective approach as it utilizes a lower frequency of electrical stimulation, which can help to prevent tolerance and maintain the pain-relieving effects.

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26.

During initial standing a patient is pushing backward displacing the center-of-mass at or near the posterior limits of stability. The most likely cause of this is contraction of the:
- Gastrocnemius-soleus.
- Hamstrings.
- Hip extensors
- tibialis anterior/peroneals.
Correct Answer

A. Gastrocnemius-soleus.

Explanation

During initial standing, the patient is pushing backward, which indicates a posterior displacement of the center-of-mass. The gastrocnemius-soleus muscles are responsible for plantarflexion of the ankle joint, which helps to maintain balance and stability in an upright position. Contraction of these muscles would cause a backward push, displacing the center-of-mass towards the posterior limits of stability. Therefore, the most likely cause of this backward push during initial standing is the contraction of the gastrocnemius-soleus muscles.

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27.

A patient has been screened using a new test for the presence of a gene (ALG-2) linked to Alzheimer’s disease. His physician reports he lacks the gene and should not be at increased risk to develop the disease. Some years later he develops Alzheimer’s and a repeat test reveals the presence of the gene. The results of the initial test can be interpreted as:
- False negative.
- False positive.
- High degree of sensitivity.
- High degree of specificity.
Correct Answer

A. False positive.

Explanation

The initial test result can be interpreted as a false positive. A false positive result occurs when the test incorrectly indicates the presence of a condition or gene when it is not actually present. In this case, the patient was initially reported to lack the ALG-2 gene linked to Alzheimer's disease, but later it was revealed that the gene was actually present. Therefore, the initial test result was incorrect and can be considered a false positive.

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28.

A 62 year-old lives at home with his wife and adult daughter. He has recently been diagnosed with multi-infarct dementia and is recovering from a fractured hip following a fall injury. In your initial interview with his wife you would expect to find:
- Agitation and sundowning.
- History of steady progression of loss of judgment and poor safety awareness.
- History of sudden onset of new cognitive problems and patchy distribution of deficits.
- Perseveration on a thought or activity.
Correct Answer

A. Agitation and sundowning.

Explanation

In the given scenario, the patient is a 62-year-old with multi-infarct dementia and a fractured hip. Agitation and sundowning are common symptoms associated with dementia. Sundowning refers to increased confusion, restlessness, and agitation that often occurs in the late afternoon or evening. This symptom can be exacerbated by changes in the environment, such as transitioning from day to night. Therefore, it is expected to find agitation and sundowning in the initial interview with the patient's wife.

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29.

A fourteen-year-old girl complains of subpatellar pain after participation in an aerobic exercise program for two weeks. Your examination shows a large Q angle, pain with palpation at the inferior pole of the patella, and mild swelling at both knees. Physical therapy intervention should promote:
- Hamstring strengthening.
- lateral patellar tracking.
- vastus lateralis strengthening.
- Vastus medialis muscle strengthening.
Correct Answer

A. lateral patellar tracking.

Explanation

The correct answer is lateral patellar tracking. In this scenario, the patient is experiencing subpatellar pain, which is commonly associated with patellofemoral pain syndrome (PFPS). The presence of a large Q angle, pain at the inferior pole of the patella, and mild swelling at both knees suggests that the patella is not tracking properly within the femoral groove. Lateral patellar tracking occurs when the patella deviates too far towards the outside of the knee, causing increased stress and pain. Therefore, physical therapy intervention should focus on promoting proper alignment and tracking of the patella to alleviate symptoms.

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30.

You receive a referral from an acute care physical therapist to treat a patient with right hemiparesis in the home. The referral indicates that the patient demonstrates good recovery: both involved limbs are categorized as stage 4 (Brunnstrom recovery stages). He is ambulatory with an small-based quad cane. The activity that would be MOST appropriate for a patient at this stage of recovery is:
- Sitting, marching in place (alternate hip flexion movements).
- Standing, picking the foot up behind and slowly lowering it.
- standing, small range knee extension to gain quadriceps control.
- supine, bending the hip and knee up to the chest with some hip abduction.
Correct Answer

A. standing, small range knee extension to gain quadriceps control.

Explanation

The patient is in stage 4 of Brunnstrom recovery stages, indicating good recovery. At this stage, the patient has voluntary movement and can perform basic functional activities. The most appropriate activity for a patient at this stage would be to focus on gaining quadriceps control. Standing and performing small range knee extensions will help strengthen the quadriceps muscles and improve stability during ambulation with a quad cane. This activity will also promote further functional independence and improve the patient's overall mobility.

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31.

During a physical therapy session for low back pain, a 67 year-old patient tells you that she has had urinary incontinence for the last year. It is particularly problematic when she has a cold and coughs a lot. She has not told her doctor about this problem because she is too embarrassed. Your BEST course of action is to:
- Examine the patient and proceed with her back treatment.
- Examine the patient, document and discuss your findings with the doctor.
- examine the patient, document the problems, then send her back to her doctor.
- Refer the patient back to her doctor.
Correct Answer

A. Examine the patient, document and discuss your findings with the doctor.

Explanation

The best course of action in this scenario is to examine the patient, document and discuss the findings with the doctor. Urinary incontinence can be a symptom of an underlying medical condition, and it is important to address it with the patient's primary care physician. By documenting and discussing the findings, the therapist can ensure that the patient receives appropriate medical attention and treatment for her urinary incontinence, in addition to her back pain.

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32.

During a sensory exam you determine that a patient complains of a dull, aching pain but is not able to discriminate a stimulus as sharp or dull. Two-point discrimination is absent. Based on these findings, the pathway that is intact is the:
- anterior spinothalamic tract.
- dorsal columns/neospinothalamic systems.
- fasciculus gracilis/medial lemniscus.
- Lateral spinothalamic tract.
Correct Answer

A. anterior spinothalamic tract.

Explanation

Based on the findings that the patient complains of a dull, aching pain but is unable to discriminate a stimulus as sharp or dull, and that two-point discrimination is absent, it suggests that the pathway responsible for transmitting these sensations is intact. The anterior spinothalamic tract is responsible for transmitting crude touch and pressure sensations, which aligns with the patient's complaint of a dull, aching pain. Therefore, the intact pathway in this case is the anterior spinothalamic tract.

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33.

A patient is five days post-MI and is receiving cardiac rehabilitation. At this time a goal that would be INAPPROPRIATE is to:
- counteract deconditioning associated with bed rest.
- educate the patient and family regarding risk factor reduction.
- increase the patient’s maximal oxygen consumption by discharge.
- Initiate early return to independence in activities of daily living.
Correct Answer

A. educate the patient and family regarding risk factor reduction.

Explanation

The goal of educating the patient and family regarding risk factor reduction is not inappropriate because it is an important aspect of cardiac rehabilitation. After a myocardial infarction (MI), it is crucial to educate the patient and their family about lifestyle modifications and risk factor reduction to prevent future cardiac events. This may include discussing the importance of a healthy diet, regular exercise, smoking cessation, and managing stress. By providing this education, healthcare professionals can empower the patient and their family to make informed decisions and take control of their cardiovascular health.

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34.

A 73 year-old man has bilateral short transfemoral (AK) amputations and will require a wheelchair for functional mobility in the home and community. An appropriate prescription for his wheelchair includes:
- Increasing the seat depth by 2 inches to accommodate the length of the residual limbs.
- Lowering the seat height by 3 inches.
- Placement of the drive wheels 2 inches anterior to the vertical back supports.
- Placement of the drive wheels 2 inches posterior to the vertical back supports.
Correct Answer

A. Placement of the drive wheels 2 inches anterior to the vertical back supports.

Explanation

Placing the drive wheels 2 inches anterior to the vertical back supports is the correct answer because it allows for better weight distribution and stability for the user with bilateral short transfemoral amputations. This positioning helps to prevent the wheelchair from tipping forward, as the user's center of gravity is shifted towards the front due to the absence of lower limbs. Additionally, having the drive wheels placed anteriorly allows for easier maneuverability and control of the wheelchair.

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35.

A multicenter study was done on the reliability of passive wrist flexion and extension goniometric measurements using volar/dorsal alignment, ulnar alignment and radial alignment. Significant differences were revealed between the three techniques. An appropriate level for determining significant difference is a P value of:
- P=0.015
- P=0.05
- P=0.1
- P=0.5
Correct Answer

A. P=0.05

Explanation

The appropriate level for determining significant difference is a P value of 0.05. This means that if the calculated P value is less than 0.05, then the observed differences between the three techniques are considered statistically significant. In other words, there is a 5% chance that the observed differences are due to random chance alone, and a 95% chance that they are truly different.

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36.

In treating a patient with a diagnosis of right shoulder impingement syndrome, the therapist should not allow the patient to perform assisted repetitive overhead exercises without FIRST:
- Controlling all pain.
- Having complete AROM at the shoulder.
- instruction in proper postural alignment.
- stretching the shoulder girdle muscles.
Correct Answer

A. instruction in proper postural alignment.

Explanation

In order to effectively treat a patient with right shoulder impingement syndrome, it is important for the therapist to first provide instruction in proper postural alignment. This is because poor posture can contribute to shoulder impingement and exacerbate symptoms. By addressing postural alignment, the therapist can help the patient avoid movements or positions that may further impinge the shoulder joint. Once proper alignment is established, the therapist can then progress to other interventions such as controlling pain, improving range of motion, and stretching the shoulder girdle muscles.

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37.

An older person with a diagnosis of degenerative joint disease should understand his disease, its progression, and its management. You will know your patient education has been effective if he can tell you:
- Aerobic conditioning is not appropriate when pain is present and medications must be used.
- Joint protection strategies are important but cannot reduce the expected loss of function.
- Loss of ROM and immobility are expected and irreversible.
- Pain and stiffness are worse in the early morning and should decrease with moderate activity.
Correct Answer

A. Loss of ROM and immobility are expected and irreversible.

Explanation

The correct answer is loss of ROM and immobility are expected and irreversible. This answer is the most accurate because degenerative joint disease is a progressive condition that leads to the deterioration of the joints over time. As a result, the patient can expect a loss of range of motion (ROM) and immobility, which are irreversible. The other options mentioned in the question are not necessarily true for all cases of degenerative joint disease.

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38.

A 34 year-old patient is recently admitted to your facility with a diagnosis of Guillain-Barré syndrome. In your initial examination, you expect to find:
- asymmetrical weakness with hyperreflexia, bulbar palsy.
- Glossopharyngeal and vagal paralysis with hyperactive jaw and snout reflexes.
- Sensory loss (stocking and glove distribution) with minor loss of motor function.
- Symmetrical distribution of weakness, ascending with possible involvement of lower cranial nerves.
Correct Answer

A. asymmetrical weakness with hyperreflexia, bulbar palsy.

Explanation

In Guillain-Barré syndrome, there is typically an ascending pattern of weakness that starts in the legs and progresses upwards. The weakness is usually symmetrical, affecting both sides of the body equally. However, in some cases, the weakness may be asymmetrical, meaning it may be more pronounced on one side of the body. Hyperreflexia, which is an exaggerated reflex response, is also commonly seen in Guillain-Barré syndrome. Bulbar palsy refers to weakness or paralysis of the muscles involved in swallowing and speaking, which can occur in this condition. Therefore, the presence of asymmetrical weakness with hyperreflexia and bulbar palsy is consistent with the diagnosis of Guillain-Barré syndrome.

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39.

A 31 year-old patient presents with patellar tendinitis as a result of a mountain climbing accident three weeks ago. The patient complains of pain on resisted knee extension, stair climbing, and sit-to-standing movements. You choose to apply iontophoresis using a pain medication with a positive charge. The correct current type, polarity and active electrode placement is:
- Biphasic current with the cathode placed proximal on the tendon.
- low volt continuous current with the anode placed distal on the tendon.
- monophasic current with the anode placed on the tendon.
- monophasic current with the cathode placed on the tendon.
Correct Answer

A. monophasic current with the anode placed on the tendon.

Explanation

The correct answer is monophasic current with the anode placed on the tendon. Monophasic current is used for iontophoresis because it allows for the delivery of medication through the skin. The anode, which is the positive electrode, should be placed on the tendon to attract the positively charged pain medication and facilitate its absorption into the tissues. This treatment approach aims to reduce inflammation and alleviate pain in the patellar tendon.

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40.

A 52 year-old patient sustained a T10 spinal cord injury four years ago. During initial examination you observe redness over the ischial seat that persists for 10 minutes when not sitting. The BEST intervention in this case would be to:
- Change to a low density wheelchair cushion.
- Have the patient do sitting push-ups at least every 10 minutes.
- Increase the arm rest height.
- order a tilt-in-space wheelchair.
Correct Answer

A. Increase the arm rest height.

Explanation

Increasing the arm rest height would be the best intervention in this case because the patient has a T10 spinal cord injury, which affects the sensory and motor function below the level of the injury. The redness over the ischial seat that persists for 10 minutes when not sitting suggests the presence of pressure ulcers or skin breakdown. By increasing the arm rest height, it helps to redistribute the pressure and relieve the pressure on the ischial seat, reducing the risk of further skin damage. This intervention promotes proper positioning and pressure relief, which is crucial for preventing pressure ulcers in patients with spinal cord injuries.

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41.

A 16 year-old adolescent female was sent to physical therapy with a diagnosis of anterior knee pain. Positive findings include pes planus, lateral tibial torsion and genu valgum. The position the femur will be in is excessive:
- Abduction.
- Lateral rotation.
- medial rotation.
- retroversion.
Correct Answer

A. Abduction.

Explanation

The correct answer is abduction. In this case, the positive findings of pes planus, lateral tibial torsion, and genu valgum suggest that the individual has a misalignment of the lower extremities. Abduction refers to the movement of a body part away from the midline of the body. In the context of the femur, excessive abduction would mean that the femur is deviating away from the midline of the body, contributing to the misalignment and anterior knee pain.

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42.

A 24 year-old patient in a coma recovering from traumatic brain injury is receiving PROM exercises. The family is confused because the occupational therapist has told them to do range of motion exercises in a different way than the physical therapist had instructed. As the physical therapist it would be BEST to deal with this situation by telling the family:
- the PT and OT supervisors will review and correct any discrepancies in the exercise program.
- There is no need for them to worry and note the problem in the patient’s record.
- to exercise the way you instructed until any differences can be worked out with the occupational therapist.
- You will meet with the occupational therapist to discuss the exercise approaches and you will let them know the outcome of the meeting as soon as possible.
Correct Answer

A. to exercise the way you instructed until any differences can be worked out with the occupational therapist.

Explanation

The best way for the physical therapist to deal with the situation is to instruct the family to continue exercising the way they were originally instructed until any differences can be resolved with the occupational therapist. This approach ensures that the patient's exercise routine remains consistent and avoids any confusion or potential harm from conflicting instructions. By addressing the issue directly with the occupational therapist, the physical therapist can work towards resolving any discrepancies and provide the family with an update as soon as possible.

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43.

You are working with a 10 year-old girl with cerebral palsy. Part of the exercises in her plan of care involve using the Swiss ball. The choice of educational media that is BEST to use when instructing her in use of this device is:
- a oral presentation that uses transparencies of Swiss ball positions.
- a slide presentation of exercises using the Swiss ball.
- A videotape of another child with cerebral palsy on a Swiss ball.
- printed handouts with stick figure drawings and instructions.
Correct Answer

A. A videotape of another child with cerebral palsy on a Swiss ball.

Explanation

A videotape of another child with cerebral palsy on a Swiss ball would be the best choice of educational media for instructing the 10-year-old girl with cerebral palsy in the use of the Swiss ball. This visual medium would provide the girl with a clear and concrete example of how to use the Swiss ball effectively. By observing another child with the same condition using the Swiss ball, she can better understand the proper techniques and exercises involved. This visual demonstration can be more engaging and relatable for the girl, making it easier for her to learn and follow along.

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44.

As a physical therapist you are the health professional in charge during a high school football game. During the game, a player is tackled violently by two opponents. You determine that the player is unresponsive. Your immediate course of action should be to:
- ask for help to log roll the player on his back while stabilizing his neck.
- Open the airway by using the chin-lift method.
- Stabilize the neck and flip back the helmet face mask.
- Summon emergency medical services.
Correct Answer

A. Stabilize the neck and flip back the helmet face mask.

Explanation

The correct answer is to stabilize the neck and flip back the helmet face mask. This is the immediate course of action because the player is unresponsive, indicating a potential neck or spinal injury. Stabilizing the neck helps prevent further damage and movement that could worsen the injury. Flipping back the helmet face mask allows for better access to the airway and breathing. Summoning emergency medical services should also be done, but stabilizing the neck and ensuring proper airway management take priority in this situation.

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45.

During a home visit, the mother of an 18 month-old child with developmental delay and an atrio-ventricular shunt for hydrocephalus tells you that her daughter vomited several times, was irritable and is now lethargic. Your BEST course of action is to:
- Call the girl’s pediatrician immediately.
- Give the child a cold bath to try and rouse her.
- give the child clear liquids since she vomited.
- Place the child in a sidelying position and monitor vital signs.
Correct Answer

A. Give the child a cold bath to try and rouse her.
46.

A 24 year-old woman recently delivered twins on the obstetrical service of your hospital. After delivery she has developed a 4 centimeter diastasis recti abdominis. The BEST initial intervention for this problem is to teach:
- Gentle stretching of hamstrings and hip flexors
- pelvic floor exercises and sit-ups.
- Pelvic tilts and bilateral straight leg raising.
- Protection and splinting of the abdominal musculature.
Correct Answer

A. pelvic floor exercises and sit-ups.
47.

The optimal position for ventilation of a patient with a C5 complete spinal cord injury is:
- Semi Fowler’s
- Sidelying, head of bed elevated 45 degrees
- Sidelying, head of bed flat
- Supine, head of bed flat
Correct Answer

A. Sidelying, head of bed flat

Explanation

The optimal position for ventilation of a patient with a C5 complete spinal cord injury is sidelying with the head of the bed flat. This position helps to maintain proper alignment of the airway and allows for effective ventilation. Sidelying also helps to prevent aspiration and facilitates secretion drainage. Keeping the head of the bed flat ensures that the patient's airway is not compromised and allows for better lung expansion.

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48.

A 16 year-old patient with osteosarcoma is being seen in physical therapy for crutch training. Her parents have decided not to tell her about her diagnosis. She is quite perceptive and asks you directly if she has cancer and about her future. Your BEST course of action is to:
- Change the subject and discuss the plans for that day’s treatment.
- Discuss her condition gently indicating her parent’s fears about not telling her the diagnosis.
- schedule a conference with the doctor and family about her condition and your discussions with the patient.
- tell the patient that you don’t know the specifics of her condition or prognosis, and she should speak with her doctor.
Correct Answer

A. Discuss her condition gently indicating her parent’s fears about not telling her the diagnosis.

Explanation

The best course of action in this situation is to discuss the patient's condition gently, indicating her parent's fears about not telling her the diagnosis. This approach respects the parents' decision while also addressing the patient's concerns and providing some information about her condition. It allows for open communication and gives the patient an opportunity to ask questions or express her feelings. Scheduling a conference with the doctor and family may be necessary in the future, but for now, it is important to address the patient's immediate concerns.

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49.

Your patient has had amyotrophic lateral sclerosis for the past two years with mild functional deficits. He is still ambulatory with bilateral canes but is limited in his endurance. An important goal for his physical therapy plan of care should be to prevent:
- Further gait deterioration as a result of ataxia.
- Myalgia.
- Overwork damage in weakened, denervated muscle.
- Radicular pain and paresthesias.
Correct Answer

A. Myalgia.

Explanation

The correct answer is myalgia. Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease that affects the motor neurons in the brain and spinal cord. It leads to muscle weakness and atrophy over time. As the patient in this scenario still has mild functional deficits and is ambulatory with canes, it is important to prevent myalgia, which refers to muscle pain and soreness. This can occur due to overuse or strain on weakened and denervated muscles. By addressing and managing myalgia, the physical therapy plan of care can help improve the patient's quality of life and maintain their functional abilities.

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Quiz Edited by
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Pt/Ot Haad Simulation 7

Common compensatory postures you would expect for a patient diagnosed with fixed severe forefoot varus are:

A patient has undergone surgery and subsequent immobilization to stabilize the olecranon process. The patient now exhibits an elbow flexion contracture. In this case, an absolute CONTRAINDICATION for joint mobilization would be:

You observe a physical therapist assistant ambulate a patient for the first time after a left total hip replacement. The patient is using crutches and is practicing on a level surface. The PTA should guard the patient by standing slightly:

A 13 year-old severed the median nerve three days ago when his hand went through a glass window. To determine the motor function of the nerve you perform a chronaxie test. At this time you would expect the chronaxie of the nerve to be:

A patient has lumbar spinal stenosis encroaching on the spinal cord. The physical therapist should educate the patient to AVOID:

A patient with post-polio syndrome presents in your clinic with symptoms of myalgia and increasing fatigue. He is wearing a KAFO which he has had for 10 years. When walking, you observe that he rises up over the sound limb to advance the orthotic limb forward. Your BEST intervention is to provide:

Your patient has moderate spasticity of the biceps brachii on the left as a result of a CVA. You choose to use electrical stimulation to temporarily decrease the effects of hypertonicity in order to work on ADL activities. Your objective in applying the current is to:

You are working with a four year-old child who has myelodysplasia at the L5 level. At this level the most appropriate orthosis to recommend for ambulation would be a (an):

A 26 year-old female has a 3 year history of multiple sclerosis. One of her disabling symptoms is a persistent and severe diplopia which leaves her frequently nauseated and immobile. An appropriate intervention strategy to assist her in successfully participating in rehabilitation would be to:

The MOST appropriate positioning strategy for a patient recovering from acute stroke who is in bed and demonstrates a flaccid upper extremity is:

A patient presents with a large plantar ulcer that will be debrided in the whirlpool. The foot is cold, pale, and painless. The condition that would most likely result in this clinical presentation is:

While setting a patient up for cervical traction, you notice a purplish mole with rough edges on the patient’s neck. You:

You have received a referral for a 42 year-old patient who has a neurapraxia involving the ulnar nerve secondary to an elbow fracture. Based on your knowledge of this condition, you expect that:

After three weeks of teaching a patient how to ambulate with bilateral crutches and a touch down gait, you determine the most appropriate kind of feedback to give to the patient is:

Physical therapy intervention for a sixty-five year-old male patient with a recent diagnosis of supraspinatus tendinitis with possible impingement syndrome of the right shoulder should emphasize:

The recommended time duration for endotracheal suctioning is:

A 76 year-old frail older adult is confined to bed in a nursing facility. He has developed a small superficial wound over the sacral area. Since only small amounts of necrotic tissue are present, the physician has decided to use autolytic wound debridement. This is BEST achieved with:

During initial standing a patient is pushing backward displacing the center-of-mass at or near the posterior limits of stability. The most likely cause of this is contraction of the:

A 62 year-old lives at home with his wife and adult daughter. He has recently been diagnosed with multi-infarct dementia and is recovering from a fractured hip following a fall injury. In your initial interview with his wife you would expect to find:

A fourteen-year-old girl complains of subpatellar pain after participation in an aerobic exercise program for two weeks. Your examination shows a large Q angle, pain with palpation at the inferior pole of the patella, and mild swelling at both knees. Physical therapy intervention should promote:

During a sensory exam you determine that a patient complains of a dull, aching pain but is not able to discriminate a stimulus as sharp or dull. Two-point discrimination is absent. Based on these findings, the pathway that is intact is the:

A patient is five days post-MI and is receiving cardiac rehabilitation. At this time a goal that would be INAPPROPRIATE is to:

A 73 year-old man has bilateral short transfemoral (AK) amputations and will require a wheelchair for functional mobility in the home and community. An appropriate prescription for his wheelchair includes:

In treating a patient with a diagnosis of right shoulder impingement syndrome, the therapist should not allow the patient to perform assisted repetitive overhead exercises without FIRST:

An older person with a diagnosis of degenerative joint disease should understand his disease, its progression, and its management. You will know your patient education has been effective if he can tell you:

A 34 year-old patient is recently admitted to your facility with a diagnosis of Guillain-Barré syndrome. In your initial examination, you expect to find:

A 52 year-old patient sustained a T10 spinal cord injury four years ago. During initial examination you observe redness over the ischial seat that persists for 10 minutes when not sitting. The BEST intervention in this case would be to:

A 16 year-old adolescent female was sent to physical therapy with a diagnosis of anterior knee pain. Positive findings include pes planus, lateral tibial torsion and genu valgum. The position the femur will be in is excessive:

You are working with a 10 year-old girl with cerebral palsy. Part of the exercises in her plan of care involve using the Swiss ball. The choice of educational media that is BEST to use when instructing her in use of this device is:

As a physical therapist you are the health professional in charge during a high school football game. During the game, a player is tackled violently by two opponents. You determine that the player is unresponsive. Your immediate course of action should be to:

During a home visit, the mother of an 18 month-old child with developmental delay and an atrio-ventricular shunt for hydrocephalus tells you that her daughter vomited several times, was irritable and is now lethargic. Your BEST course of action is to:

A 24 year-old woman recently delivered twins on the obstetrical service of your hospital. After delivery she has developed a 4 centimeter diastasis recti abdominis. The BEST initial intervention for this problem is to teach:

The optimal position for ventilation of a patient with a C5 complete spinal cord injury is:

A 16 year-old patient with osteosarcoma is being seen in physical therapy for crutch training. Her parents have decided not to tell her about her diagnosis. She is quite perceptive and asks you directly if she has cancer and about her future. Your BEST course of action is to:

Your patient has had amyotrophic lateral sclerosis for the past two years with mild functional deficits. He is still ambulatory with bilateral canes but is limited in his endurance. An important goal for his physical therapy plan of care should be to prevent: